The next step is to identify deeper probable causes (more ribs) in the people category (see Figure 4). As the team identifies each possible deeper cause they need to be asked "why" as each potential cause is identified.
- Why is there a lack of training for new staff?
- Why do you think the shift supervisor lacks experience?
- Why is there not enough staff?
- Why is there an increase in sick leave?
- Why is there a reliance on locums in the department?
- Why is there poor project management?
When the team was asked why there was a lack of training for new staff time to do the training, time was the main reason. Taking the time to properly train new staff did result in the new staff, including the locums having to ask fewer questions or refer to the procedure manual as frequently, thus increasing their work and productivity.
When asked why the team thought the shift supervisors lacked experience, it was because there were multiple shift supervisors, with some being new hires with a lack of training. Providing more training to supervisors, replacing a combative supervisor, and getting them all on the same page improved staff attitudes and resulted in improved productivity. The team determined that being overworked, having poor morale, and experiencing COVID infections were the primary reasons for more sick leave. Once the team felt empowered, sick leave was reduced significantly. The team also determined that increased sick leave due to COVID increased locums.
The team identified a project, such as implementing a new method, was slowed down due to lack of time and inexperienced staff.
When all this is added to the Fishbone Analysis chart, solutions can then be suggested.
